Table 5 Criteria to differentiate ADEM from MS (from ref. [29] modified)

Demographic

More frequent in young subjects (<10–12 years); no gender predilection

More frequent in adolescents;

girls more affected than boys

Prior flu-like illness

Very frequent

Variable

Symptoms

 ▪ Seizures

Variable

Rare

 ▪ Encephalopathy

Required in definition

Rare early in the disease

 ▪ Discrete event

A single event can fluctuate over the course of 12 weeks

Discrete events separated by at least 4 weeks

MRI:

 ▪ Large lesions involving gray and white matter

Frequent

Rare

 ▪ Enhancement

Frequent

Frequent

 ▪ Longitudinal MRI findings

Lesions typically either resolve or show only residual findings

Typically associated with development of new lesions

CSF

 ▪ Pleocytosis

Variable

rare, white blood cell count almost always < 50

 ▪ Oligoclonal bands

Variable

Frequent